| Hospital | Address | Code | Price | Last Updated |
|---|---|---|---|---|
| Ascension Calumet Hospital | 614 Memorial Dr, Chilton | J1040 | $18 [source] | 4 years ago |
| Aspirus Medford Hospital | 135 S Gibson St, Medford | J1040 | $28 [source] | 4 years ago |
| Aspirus Divine Savior Hospital | 2817 New Pinery Rd, Portage | J1040 | $28 [source] | 4 years ago |
| Aspirus Riverview Hospital | 410 Dewey St, Wisconsin Rapids | J1040 | $28 [source] | 4 years ago |
| Aspirus Stevens Point Hospital | 5409 Vern Holmes Dr, | J1040 | $28 [source] | 4 years ago |
| Aspirus Langlade Hospital | 110 E 5Th Ave, Antigo | J1040 | $28 [source] | 4 years ago |
| Aspirus Wausau Hospital | 333 Pine Ridge Blvd, Wausau | J1040 | $28 [source] | 4 years ago |
| Orthopaedic Hospital Of Wisconsin | 475 W River Woods Pkwy, Milwaukee | J1040 | $36 [source] | 4 years ago |
| Chippewa Valley Hospital & Oakview Care Center, Inc. | 1220 3Rd Ave W, Durand | J1040 | $53 [source] | 4 years ago |
| Prairie Ridge Health | 1515 Park Ave, Columbus | J1040 | $85 [source] | 4 years ago |
| Essentia Health St. Mary's Hospital-Superior | 3500 Tower Ave, Superior | J1040 | $92 [source] | 4 years ago |
| Watertown Regional Medical Center | 125 Hospital Drive, Watertown | J1040 | $158 [source] | 4 years ago |
| Upland Hills Health | 800 Compassion Way, Dodgeville | J1040 | $176 [source] | 4 years ago |